Original Publication
Open Access

Video Curriculum on Screening for the Social Determinants of Health

Published: October 9, 2013 | 10.15766/mep_2374-8265.9575

Included in this publication:

  • CCH Legal Aid Training Scene1 Bad 2011 (Public Benefits).m4v
  • CCH Legal Aid Training Scene1 Good 2011 (Public_Benefits).m4v
  • CCH Legal Aid Chrissy 4 2011 Day in the Life Video Public Benefits.m4v
  • CCH Legal Aid Shaiheim 4 2011 Day in the Life Video Education.m4v
  • CCH Legal Aid Training Scene2 Bad 2011 (Housing).m4v
  • CCH Legal Aid Training Scene2 Good 2011 (Housing).m4v
  • CCH Legal Aid Training Scene3 Bad 2011 (Maternal Depression Domestic Violence).m4v
  • CCH Legal Aid Training Scene3 Good 2011 (Maternal Depression Domestic Violence).m4v
  • CCH Legal Aid Training Scene4 Bad 2011 (Education).m4v
  • CCH Legal Aid Training Scene4 Good 2011 (Education).m4v
  • Direct Observation Tool.docx
  • Domestic Violence and Maternal Depression.docx
  • Education.docx
  • Food Insecurity.docx
  • Help one family at a time Benefits and Housing Make a Difference.pptx
  • Housing.docx
  • Instructor's Guide.docx
  • Maternal Depression Domestic Violence Education Screening Can Make a Difference.pptx
  • Parent Guardian Survey Tool.docx
  • Resident Survey Tool.docx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. This publication includes large downloadable files. If you experience difficulty downloading these files, please contact mededportal@aamc.org to receive a free DVD version via mail.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

Introduction: Social determinants of health (SDH) are emerging as a major barrier to the promotion of child health in the twenty-first century. The effects of poverty, including food insecurity, unsafe housing conditions, inadequate educational interventions, domestic violence, and limited access to medical care, have been linked to poor health and developmental outcomes in children. Many pediatric residents lack competence in identifying families that face social, economic, or environmental difficulties and feel inadequately prepared to counsel and refer patients and families to appropriate community resources due to their limited training during medical school and early residency years. Methods: This curriculum was developed following a needs assessment and positive feedback obtained after a brief one-time educational experience with videotaped social history vignettes. Scripts for a series of appropriate and inappropriate video vignettes depicting typical scenarios of resident physicians screening for SDH in continuity clinic were developed, with clinic parents and resident physicians acting in their respective roles. A series of “Day in the Life” videos was also created to allow actual patients and families from the clinic tell their story of how screening, detection, and intervention impacted their family’s lives. Residents experience this resource by attending the included didactic PowerPoint presentation, viewing the appropriate/inappropriate vignettes, engaging in group discussion, viewing the “Day in the Life” videos, and participating in a final discussion. Results: The vast majority (> 95%) of participating residents strongly agreed/agreed that this education addressed important topics and included a good combination of both didactic and interactive components. Resident selfrated competence in screening for housing, benefits, and educational concerns significantly improved (p < 0.05 for each). Parents seen by residents who received this education reported that the resident was significantly more likely to screen for both domestic violence and depression. Although not significant, parents also recalled being screened more frequently for food insecurity, public benefits issues, housing, and educational needs. Discussion: Many pediatric residents lack competence in counseling and referring patients and families to appropriate community resources. Additionally, the majority of pediatric residents were not raised in poverty, so they cannot build upon their past experiences. Through the use of these vignettes, videotaped first-hand accounts, and discussions, residents are better equipped to identify and aid families in need.


Educational Objectives

By the end of this session, learners will be able to:

  1. Recognize the barriers to health facing patients and families from diverse socio-economic backgrounds.
  2. Discuss empathetic engagement of patients and families in an attempt to maximize residents’ effectiveness in screening for social determinants of health (SDH).
  3. Formulate a plan to mitigate the effects of SDH through referrals to government agencies and/or community resources.

Author Information

  • Melissa Klein, MD: Cincinnati Children's Hospital Medical Center
  • Andrew Beck: Cincinnati Children's Hospital Medical Center
  • Robert Kahn: Cincinnati Children's Hospital Medical Center
  • Adrienne Henize: Cincinnati Children's Hospital Medical Center
  • Jennifer O'Toole: Cincinnati Children's Hospital Medical Center
  • Alicia Alcamo: Cincinnati Children's Hospital Medical Center
  • Daniel McLinden: Cincinnati Children's Hospital Medical Center

Disclosures
None to report.

Funding/Support
None to report. 

Prior Presentations
Give me your tired, your poor, and your huddled masses: Developing an innovative curriculum to teach residents to address the social determinants of health. Presented at: Association of Pediatric Program Directors Meeting; April 2013; Nashville, TN.

Teaching Today’s Healthcare Providers: Using an innovative video curriculum to impact screening for social determinants of health. Presented at : The National Medical Legal Partnership Meeting; April 2013; Washington, DC.



Citation

Klein M, Beck A, Kahn R, et al. Video curriculum on screening for the social determinants of health. MedEdPORTAL. 2013;9:9575. https://doi.org/10.15766/mep_2374-8265.9575